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Characterization and evaluation of prognostic factors of feline spontaneous malignant mammary tumors
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Abstract(s)
Os tumores da glândula mamária são uma das neoplasias mais comuns em felinos. Estão associados a elevadas taxas de malignidade e mau prognóstico, resultando numa morbilidade e mortalidade elevadas. Nesse sentido, a definição de fatores de risco e de prognóstico são essenciais, no sentido de auxiliar a estabelecer um plano terapêutico e a prever a sua evolução.
Os objetivos principais deste estudo retrospetivo consistiram em fazer uma caraterização dos casos de lesões mamárias espontâneas em gatas domésticas que se apresentaram à consulta em três centros de atendimento médico veterinário de Portugal entre 2010 e 2020, e avaliar potenciais fatores de prognóstico de tumores mamários malignos espontâneos.
Foram recolhidos dados clínicos de 116 gatas que foram apresentadas à consulta devido à presença de massas mamárias. Destas, 95 apresentavam tumores mamários malignos (num total de 114 tumores malignos), três gatas foram diagnosticadas com tumores mamários benignos e 18 tinham alterações mamárias não neoplásicas.
Este estudo proporcionou uma caracterização detalhada dos tumores mamários de gatas. Sessenta e sete gatas foram incluídas na análise estatística de acompanhamento dos animais, que envolveu um total de 21 parâmetros. Na análise univariada, 11 fatores analisados mostraram uma correlação negativa estatisticamente significativa com o tempo de sobrevida, incluindo o tamanho do tumor, invasão de linfonodos, metástases distantes, estadio clínico, tipo de cirurgia, margens cirúrgicas, tipo de crescimento do tumor, necrose do tumor, invasão linfovascular, pleomorfismo nuclear e grau histológico. Sete destes fatores tiveram também uma correlação negativa significativa com o tempo livre de doença, nomeadamente o tamanho do tumor, estadio clínico, margens cirúrgicas, tipo de crescimento do tumor, invasão linfovascular, pleomorfismo nuclear e grau histológico. A regressão multivariada de avaliação da influência global dos diferentes fatores sobre o tempo livre de doença apresentou um valor elevado (R2 ajustado de 0,90).
Tumors of the mammary gland are one of the most common neoplasms in cats. They are associated with high rates of malignancy and poor prognosis, resulting in high mortality. Therefore, detection of risk and prognostic factors are important in order to define therapeutic strategies and to predict the evolution of the disease. The main objectives of this retrospective study were to characterize the spontaneous mammary lesions presented by domestic cats that were evaluated at three veterinary medical centers in Portugal between 2010 and 2020, and evaluate potential prognostic factors of spontaneous malignant mammary tumors. Clinical data were collected from 116 cats that were presented due to the presence of mammary gland masses. Of these, 95 cats had malignant mammary tumors (in a total of 114 malignant tumors), three were diagnosed with benign breast tumors and 18 had non-neoplastic mammary lesions. This study provided a detailed characterization of the feline mammary tumors. Sixty-seven cats were included in the follow-up statistical analysis, which involved a total of 21 parameters. Eleven prognostic factors showed a statistically significant negative correlation with the overall survival in univariate analysis, including tumor size, lymph node invasion, distant metastasis, clinical stage, type of surgery, surgical margins, type of tumor growth, tumor necrosis, lymphovascular invasion, nuclear pleomorphism and histologic grade. Seven of these factors also showed a significant negative correlation with the disease-free interval, namely, tumor size, clinical stage, surgical margins, type of tumor growth, lymphovascular invasion, nuclear pleomorphism and histologic grade. Multiple regression of combined contribution of the different parameters analyzed in the overall survival presented a good correlation coefficient (adjusted R2 of 0,90).
Tumors of the mammary gland are one of the most common neoplasms in cats. They are associated with high rates of malignancy and poor prognosis, resulting in high mortality. Therefore, detection of risk and prognostic factors are important in order to define therapeutic strategies and to predict the evolution of the disease. The main objectives of this retrospective study were to characterize the spontaneous mammary lesions presented by domestic cats that were evaluated at three veterinary medical centers in Portugal between 2010 and 2020, and evaluate potential prognostic factors of spontaneous malignant mammary tumors. Clinical data were collected from 116 cats that were presented due to the presence of mammary gland masses. Of these, 95 cats had malignant mammary tumors (in a total of 114 malignant tumors), three were diagnosed with benign breast tumors and 18 had non-neoplastic mammary lesions. This study provided a detailed characterization of the feline mammary tumors. Sixty-seven cats were included in the follow-up statistical analysis, which involved a total of 21 parameters. Eleven prognostic factors showed a statistically significant negative correlation with the overall survival in univariate analysis, including tumor size, lymph node invasion, distant metastasis, clinical stage, type of surgery, surgical margins, type of tumor growth, tumor necrosis, lymphovascular invasion, nuclear pleomorphism and histologic grade. Seven of these factors also showed a significant negative correlation with the disease-free interval, namely, tumor size, clinical stage, surgical margins, type of tumor growth, lymphovascular invasion, nuclear pleomorphism and histologic grade. Multiple regression of combined contribution of the different parameters analyzed in the overall survival presented a good correlation coefficient (adjusted R2 of 0,90).
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Keywords
Felino Glândula mamária Prognóstico Tumores Feline Mammary gland Prognosis Tumors